If you have diabetes, should you stop eating bread, rice and pasta? While everyone with diabetes (and pre-diabetes) benefits from eliminating processed grains from their diet (foods like white rice, cold cereals, white bread and snack foods), some individuals benefit from avoiding whole grain products as well. Others can lose weight and normalize blood sugar levels while still enjoying grains. However, if you eat grains, it’s important to be picky about the type and portion size of the grains you choose.

Individuals who have difficulty losing weight and controlling blood sugar levels sometimes benefit from eliminating all grains, including whole grains, from their diets for a while. Whole and processed grains contain an easily digested type of starch that can trigger spikes in blood sugar levels after meals, leading to weight gain and many of the complications of diabetes.
Some people find that they can add whole grains back into their diets after they reach their weight and blood sugar goals. Others with diabetes can maintain good health while still enjoying grains, but find that it is important to eat only whole grains, and in moderate quantities. Serving grains as a side dish, or about ¼ of a meal, is a helpful strategy that lends itself to healthy weight management and blood sugar control.
So what are whole grains and why are they nutritionally superior to processed grains?  All true grains, including rice, wheat, barley and corn, are seeds that come from different types of grasses. A whole grain consists of three basic components: an outer layer called the bran, a starchy center called the endosperm, and a tiny, oil-packed germ, which is the part of the seed which sprouts and grows into a new plant. There is also an area just under the Bran, where many important nutrients are stored. These nutrients include magnesium, B vitamins, and some important phytochemicals, like beta-carotene, which protect plants and humans from disease.

The Grain Anatomy
When you enjoy whole grains, you benefit from every part of the grain, including all of the fiber and the nutrients that the grain stores. When you eat processed grains, like white rice or products made with white flour, you only consume the starchy center of the grain: missing out on the fiber, healthy oils, magnesium and other nutrients which actually help you maintain good blood sugar control.

For most people with diabetes, it’s almost always best to eat whole, intact grains rather than products made with whole grain flours. Whole grain flour products (like whole wheat bread, or whole grain pastas, cereals, and crackers) do contain some fiber and important nutrients, but people often find that their blood sugar levels spike (or go too high), even after eating foods made with whole grain flour.

Becase the grains in modern-day flours are ground into very fine particles, it doesn’t take much time to digest and convert the starches in the flour to sugar—resulting in a spike in blood sugar levels after meals. Flour-based foods are also more likely to increase insulin levels in our blood, which contributes to weight gain (in the belly) and some of the other complications of diabetes. However, whole, intact grains take a little longer to chew and digest and this results in a slower conversion of starch to sugar and lower blood sugar and insulin levels after meals.

Get to Know These Grains
Most Americans eat four basic grains – rice, oats, wheat and corn – but there are many healthier varieties available in most markets today. For example, barley is an economical whole grain that is an excellent substitute for rice. This humble grain contains more fiber and essential nutrients like magnesium, zinc and B vitamins than white and brown rice. Barley also has a low glycemic index and does not raise blood sugar levels as much as brown rice after meals. Barley can be used in place of rice in many dishes, including risottos, pilafs, salads and soups.

Pseudo-Grains: A Healthy Option
Quinoa, amaranth, and buckwheat are not true grains (quinoa and amaranth are related to spinach, while buckwheat is related to rhubarb) but they are the best grain-like foods to eat if you have diabetes. They each contain more protein, fiber and other important nutrients than most grains and don’t seem to raise blood sugar levels as much as true grains. While these pseudo-grains seem new and strange to most of us, people around the world have been eating them for hundreds, if not thousands of years.

Quinoa makes a delicious pilaf or hot cereal, and can also be used in grain-based salads and soups. Cream of Buckwheat cereal is an excellent, healthier option to Cream of Wheat or Malto-Meal, and toasted buckwheat pilaf (kasha) is a centuries-old Eastern European dish. Try popped amaranth as a delicious topping on yogurt or hot cereal.

If you have diabetes and/or are struggling to lose weight, experiment with different diet patterns to see what works best for you. Avoiding or reducing grains at meals can lead to rapid improvements in health for some individuals. However, it is important to follow a healthy diet that is sustainable in the long run. If you eat grains, be sure to choose only whole grain products and keep your portion to about ¼ of your plate.
For healthy, delicious and affordable recipes, check out the Your Healthy Kitchen cooking videos at YRMChealthconnect.org and follow us on Facebook at YRMC’s Your Healthy Kitchen.

Submitted by:
Yavapai Regional Medical Center